In Reply We would like to thank Dr Jolobe for the insightful comments in response to our Challenge in Clinical Electrocardiography.1 In addition to the sinus of Valsalva aneurysm rupture that we mentioned, Dr Jolobe raised acute aortic dissection and pulmonary embolism as differential diagnoses in patients with ST-segment elevation in lead aVR, especially during pregnancy and the perinatal period. New-onset cardiac murmur and detectable valvular regurgitations are valuable clues in those settings, and most importantly, careful physical examination and point-of-care echocardiography are crucial for early diagnosis.
Wang L, Su G. The Role of Echocardiography in Identifying ST-Segment Elevation Mimics—Reply. JAMA Intern Med. 2022;182(8):888. doi:10.1001/jamainternmed.2022.2205
Artificial Intelligence Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.